Tuesday, September 13, 2016

A Quick List of Precision Oncology Skeptics

Just a few days after a major report of ten oncology initiatives was produced by the Cancer Moonshot advisors (here), Derek Lowe blogged at SCIENCE about a pair of skeptical articles on precision oncology, written this year by Vinay Prasad in Nature and Lancet. A quick set of links for the curious. Further below, a short roster of some other precision medicine skeptic articles.

Update: This blog is from September 2016; for a one-time update in May 2018, here.

December 2015"Characteristics of Exceptional or Super Responders to Cancer Drugs."
Mayo Clin Proc. by Vinay Prasad and A Vandross. Here."There is incompleteness in the reporting of relevant data that may help clarify whether such responses are secondary to treatment or reflect underlying biology."

October 2015"Brave-ish New World—What’s Needed to Make Precision Oncology a Practical Reality."
JAMA Oncol. By Laura MacConaill et al. Here.

As an entry to earlier citations, see a blog on "hope and hype" in precision medicine, from August 2015 - here. See also Joyner's anti-Moonshot op ed in the January 2015 NYT here, and blog follow ups here, here.

For a parallel idea that comes from outside the mainstream "precision medicine" space, in clinical genetics there is a growing literature on defining "missing heritability" - the gap between genetics and phenotype. There are clearly crosswalks between this idea in the field of biology/clinical genetics and the concern that genomics alone will only get us so-far in curing cancers. For an open access entry point, see Blanco-Gomez, Bioessays 2016, here; see also a search of Pubmed for the phrase "missing heritability" in article titles (79 hits as of 10/1/2016). However, be aware that even the skeptical idea of "missing heritability" has its own skeptics (!),here.
___

For an example of a recent, highly positive news article in the San Diego Union, see here. For a 16p state of the art precision medicine review article, in Nature Reviews Genetics by Stanford's Euan Ashley, see here (linked from the San Diego Union news article; Nature article 9/2016).

About the Author

Bruce Quinn MD PhD is an expert on health reform, innovation, and Medicare policy. He helps both large and small companies understand and overcome hurdles to commercialization, as well as craft business strategies for a changing environment. CONTACT Dr. Quinn through www.brucequinn.com. BACKGROUND: Dr. Quinn has worked in academic medicine, Accenture business strategies, and for the Medicare program. EDUCATION: Stanford MD/PhD, MIT Postdoc, Kellogg MBA.